Do You Need A Psychologist?

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What's the difference between a psychologist and an LCSW for therapy?

You’ve decided to look for a therapist in NYC to help cope with social anxiety and you’re noticing lots of different combinations of letters after therapists’ names. What you really want is a great therapist, but you’re not sure about whether you should limit your search to psychologists or to social workers or any other of the myriad of choices (LPC, LMFT, PsyA, LMHC, and on and on). What is the difference? For this article, I will focus on the differences between psychologists and social workers (LCSWs). For the sake of transparency, I am a licensed clinical social worker and do not have a degree in psychology or licensure as a psychologist.

So, what’s the difference? Here are three areas of differentiation between psychologists and LCSWs:

1.     Training

A psychologist has typically completed at least a master’s degree in psychology, and often a doctoral degree. For licensure in NY, a doctorate is required. Upon completion of their degree program, which includes a significant number of clinical hours, psychologists in NYC are required to sit for a licensing exam. Along with passing the licensing exam, it is required to complete a significant number of hours directly with patients under the supervision of a more experienced psychologist before being eligible to call oneself a "psychologist." Only psychologists who are licensed should be providing psychotherapy in NYC.

A social worker has also typically completed at least a master’s degree in social work, and sometimes has completed a doctoral degree. Upon completion of their master’s degree program, which includes two years of direct practice through internships, social workers in NYC take a licensing exam (LMSW – licensed master of social work) that allows them to practice social work under the supervision of a more experienced social worker. After at least 3 years and a significant number of supervised hours of direct work with patients, LMSW social workers are eligible to sit for an advanced level licensing exam (LCSW – licensed clinical social worker) that tests specifically for clinical aptitude and capacity. Only social workers who are licensed at the LCSW level should be providing psychotherapy in private practice in NYC. After 3 more years of a significant number of documented and supervised practice hours at the advanced LCSW level, social workers in NYC are eligible for the “R” designation (LCSW-R) which indicates advanced training and experience specifically in providing psychotherapy.

Additional training: both psychologists and social workers are required to keep their licensure up to date by obtaining continuing education credits for trainings they attend to further their skills. Often, social workers (and some psychologists) who are interested specifically in providing psychotherapy will attend years of additional training in a specific modality of treatment such as psychodynamic or psychoanalytic psychotherapy.

2.     Testing

As part of their training and licensure, psychologists are authorized to administer cognitive and personality assessments, for example IQ tests or neuropsychological assessments which test for cognitive capacity in the instance of something like a traumatic brain injury or stroke.

Social workers are not authorized to perform psychological tests like those described above, however these types of tests may not be relevant for the kinds of issues you want to explore in therapy.

3.     Approach

Psychology is the study of the mind and mental processes related to behavior. The approach to treatment, thus, is structured around pathology of the mind and the subsequent behaviors that follow this pathology. Many psychologists are also trained in understanding family and community systems, as well as approaching patient assessment from the bio-psycho-social model (which is also utilized in social work).

Social Work is the study of how to help individuals, families, communities, and the world at large to navigate challenges that negatively impact the health and welfare of those entities. Social workers have been trained to think holistically – for example, considering a variety of approaches to a problem and considering the strengths of the individual (or family, community, world) they are working with as they frame a suggestion for moving forward.

Both LCSWs and psychologists work directly with patients in addressing issues like anxiety, depression, social anxiety, stress, relationship issues, work/life balance, trauma, etc. Unless you specifically require psychological testing, which can only be administered by a psychologist, determining which is the right fit for you depends more on the individual therapist’s approach. Social anxiety treatment, for example, might look different in every therapist’s office, regardless of whether they are a psychologist or a social worker by education and licensure.

If you are looking for a great therapist in NYC, I recommend reading one of my prior blogs about how to find a therapist in NYC and including both psychologists and LCSWs (or even just LCSW-Rs) in your search. If you’d like more input, a recommendation for a great therapist in your area, or more information about me and my practice, you are invited to contact me here to schedule a free initial consultation. I’d be happy to try to help in whatever way I can.

*Edited for accuracy.